Provider Demographics
NPI:1467906099
Name:LIVING LIFE COMMUNITY
Entity Type:Organization
Organization Name:LIVING LIFE COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-790-9664
Mailing Address - Street 1:10007 EDGEWATER TER
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5766
Mailing Address - Country:US
Mailing Address - Phone:202-790-6994
Mailing Address - Fax:
Practice Address - Street 1:10007 EDGEWATER TER
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5766
Practice Address - Country:US
Practice Address - Phone:202-790-6994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health